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General NPI Number Information
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NPI Number | 1225902984
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Entity Type | Individual
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Provider Name | BREAUNNA ANN PALMER LPCC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2025
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 3460 WASHINGTON DR STE 200
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City | EAGAN
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State | MN
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Zip | 55122-4302
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Country | US
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Telephone | 651-769-6200
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Fax | 651-769-6249
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Provider Business Mailing Address
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Address Line | 2497 7TH AVE E STE 101
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City | NORTH ST PAUL
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State | MN
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Zip | 55109-2946
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Country | US
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Telephone | 651-769-6437
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Fax | 651-769-6599
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CC05066
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License Number State | MN
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